FROM: PAULINECARPENTER@SARASHIMEDICALGROUP.WARD
DATE: Y93 M01 D14
TO: KAISER78@WHITEPLAINS.WARD
SUBJECT: RE:INFORMATION REQUEST
Dear Kaiser78,
Thank you for your e-mail about our program. At Sarashi Medical Group, we are constantly striving to be on the cutting edge of medical research, and we always appreciate those patients and prospective patients who show interest in our work. To answer your question, the landmark court case Yoshizawa v. Ministry of Public Health set the following requirements for minors wishing to begin what the law classifies as transformative hormone therapy:
- Must be over the age of 15.
- Must have written, notarized approval from legal guardians.
- Must attend at least 7 evaluations with a licensed psychiatrist and receive formal approval from the same psychiatrist. These evaluations must be no less than 1 month and no more than 2 months apart.
- Must attend at least 2 family counseling sessions with their legal guardians and any siblings or other relatives living at the same address. The first must come no less than 2 weeks and no more than 4 weeks before the first psychiatric evaluation. The second must come no less than 2 weeks and no more than 4 weeks after the final psychiatric evaluation.
- Must submit a notice to the Bureau of Vital Records no less than 3 weeks and no more than 6 weeks before beginning the approved treatment.
As you can see, it is currently illegal for minors to begin treatment without parental consent. We understand that this policy can cause difficulties for those living in socially conservative households, and we are constantly working with advocacy groups to better inform the public about the dangers of such unreasonably legal barriers. Unfortunately, we are currently unable to offer any treatment without the approval of your guardians. If you are able to get their consent, we also ask that you keep the following in mind:
- Currently, no medical insurance company based in Westward offers any plan covering treatments classified as transformative hormone therapy. Additionally, there are no plans covering any related hospital stays, outpatient procedures, or prescription medications.
- There are several ongoing legal cases in which insurance companies have refused to cover treatment for medical conditions they believe were brought on or exacerbated by a patient’s history of receiving transformative hormone therapy.
- Due to legislation banning public funding of treatments classified as transformative hormone therapy and a general lack of private funding for the same, Sarashi Medical Group requires that all patients pay their bills at the time of service. We recognize that this is often difficult for families, so we partner with several institutions to offer private financing.
- The Safe Therapies Act limits which practitioners are able to provide treatments classified as transformative hormone therapy. Sarashi Medical Group is the only practice able to offer these services in the Sarashi Metropolitan Area, and it is one of only three in the entire nation. We are also proud to say that we are the largest such practice in Westward, having twelve physicians licensed under the act.
- Because they are legally considered elective procedures rather than necessary forms of medical intervention, treatments classified as transformative hormone therapy do not qualify for the legal protections offered by the national Equality in Work and School Act. As such, patients may be required to disclose that they are receiving or have received such treatments based on institutional policies or local legislation. The legality of discrimination against patients is yet to be decided on a national level, but local courts have, thus far, ruled in favor of employers and school administrators.
We would also like to remind you that medical practitioners, pharmacists, school counselors, and teachers are required by the Parent-Child Rights Act of 71 to report interest in treatments classified as transformative hormone therapy to legal guardians. While we are unable to report to the families of minors who, like yourself, reach out to us via anonymous e-mail services, any identifying information you provide may force us to comply with this requirement.
Please know that we do not agree with these policies. It is our stance that they exist simply to discourage patients from seeking the medical assistance they require to live their lives to the fullest. In addition to mitigating damage by working with our advocacy partners, we actively try to discourage language we believe paints these treatments in a negative light. For example, we object to the phrase “transformative hormone therapy” and make it a point to remind those around us that this is a poorly-defined legal term used to refer to a broad range of treatments, not all of which involve the use of hormones or extreme changes to the body. Indeed, some of the treatments we offer have the opposite effect, instead preventing the body from undergoing changes that would cause the patient distress. Until the legislature and the courts gain a deeper understanding of these issues, however, we can do little more than comply.
Allow us to extend our sincerest apologies for not being able to help you any further. We hope that you will continue to think of us when looking for medical care in the future. In the meantime, please visit our website at sarashimedicalgroup.ward for free educational resources on the topic we have discussed today, as well as on hundreds of others.
Thank you again for reaching out to us.
Sincerely,
Dr. Pauline Carpenter
Director of Urology
Sarashi Medical Group